Gastro Health Builds a More Scalable Patient Billing Operation With AI-Powered Call Support

Growth created a new kind of operational strain

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Gastro Health is one of the country’s largest gastroenterology practices, with more than 120 locations serving a growing patient population across seven states. As the organization expanded, so did the complexity of supporting patients efficiently, especially when billing questions began pulling office teammates away from higher-value work.

Cedar has partnered with Gastro Health since 2020, powering the organization’s patient financial experience and call center. As the practice continued to grow, leadership recognized that maintaining strong performance would require a more scalable support model, one that met shifting patient demands.

“We live in an instant gratification society,” says Leo Vela, Director of Patient Financial Services at Gastro Health. “Patients want answers right away.”

That demand was increasingly showing up in ways that created friction across the organization. Office teammates were fielding questions about EOBs and balances instead of staying focused on patients. Billing questions were becoming a drag on both efficiency and experience.

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“The phones are the biggest detriment to growth and patient satisfaction. You have teammates taking a lot of calls and trying to be patient-focused, while the phones keep ringing.”

Lawrence Freni, Chief Financial Officer of Gastro Health

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Extending a strong foundation with AI

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Cedar had already helped Gastro Health modernize key parts of its patient financial experience. The next question was whether AI could take it further.

That opportunity became real when Lawrence Freni, Chief Financial Officer of Gastro Health, first saw Kora demonstrated at a Cedar event.

"It opened my eyes — this is at the forefront," he says.

Kora, Cedar’s AI voice agent, autonomously answers billing questions, explains charges, and escalates to a live agent when needed — passing along call details so agents can resolve issues faster, without starting from scratch. According to Freni, it felt like a natural next step in a partnership that had already delivered results.

For an organization growing as fast as Gastro Health, Vela saw an immediate fit: “You have to be able to scale without increasing your cost-to-collect.”

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AI that feels modern and gets smarter over time

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What stood out most to Vela was not just what Kora could do, but how it did it.

“It’s very much like speaking to a person,” he says. “A patient will interrupt and Kora stops its conversation to hear the patient.”

Patients get answers conversationally, without navigating rigid phone trees or waiting on hold when they have routine questions. For a practice headquartered in South Florida, Kora’s ability to handle inquiries in Spanish was also essential.

Just as important, Kora is not static. It continues to evolve as it learns the specific nuances of Gastro Health’s business — from common procedures to billing patterns and insurance complexity unique to gastroenterology. With each interaction, the system improves, helping resolve more issues without needing to transfer patients to a live agent.

That makes Kora more than an automation tool. It’s a forward-looking technology investment with the ability to keep pace with Gastro Health’s growth.

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“The biggest surprise was how quickly we saw results. The percentage of calls that Kora could handle entirely, the impact on agents — it exceeded our expectations.”

Leo Vela, Director of Patient Financial Services, Gastro Health

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Reducing bottlenecks and improving efficiency at scale

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Since launching in September 2025, Kora has handled more than 55,000 billing calls. For questions that require a live agent, Kora captures authentication and key details upfront — helping reduce handle time by 24% and freeing teammates to focus on conversations that require human judgment.

That's changing the economics of Gastro Health's support operation. As Kora absorbs routine call volume, fewer employees are required to service it — and staffing for Cedar-supported call center services has been reduced by 22% since launch.

These efficiency gains didn't come at the expense of experience. Post-call patient satisfaction on Kora-handled calls sits at 4 out of 5 — in line with healthcare industry benchmarks — because patients are getting answers that actually resolve their issues.

For Vela, this is a floor, not a ceiling. "The broadening of Kora's capabilities has been impressive," he says. "The more it can do, the better."

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A sustainable model for growth

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At Gastro Health, Kora is helping build a support model that is more efficient, more scalable, and better aligned to how patients want to engage.

That matters for a growing practice. As patient demand rises and expectations continue to shift, Gastro Health is investing in technology that can evolve with the business, and strengthen both financial performance and patient satisfaction.

Freni couldn’t agree more. "It is making a real difference — in both our cash flow and in our patient satisfaction,” he says. “That's how you build a sustainable growth engine."